HCV RNA LEVELS PLAY AN IMPORTANT ROLE INDEPENDENTLY OF GENOTYPE
IN PREDICTING RESPONSE TO INTERFERON THERAPY

Objective:
To evaluate the relationship between hepatitis C virus (HCV)-RNA
levels and genotypes in order to establish their potentially
predictive role in interferon (IFN) response.

Design:
To detect HCV genotype al baseline and HCV viraemia levels before
and during IFN treatment in three groups of patients with different
IFN response.

Methods:
Our study included 85 patients with biopsy-proven chronic hepatitis
C who underwent IFN therapy at standard schedule (3 MU thrice
weekly for 6 months). On the basis of IFN response they were
subdivided into three groups as follows: non responders (NR: 27
cases) when alanine aminotransferase (ALT) values (normal value: 0-
40 IU) al the end of treatment were abnormal (101.7 +/- 10.4);
responders relapsing (RR: 29 cases) when normal ALT values at the
end of therapy (28.14 +/- 1.7) increased during follow-up;
sustained (long-term) responders (LTR: 29 cases) when ALT values
remained normal for at least 12 months of follow-up (ALT values at
the end of therapy: 21.8 +/- 1.4). ALT activity was monitored
monthly during therapy and each month during 12 months of
follow-up. HCV genotype was evaluated before starting treatment
whereas HCV-RNA viraemia was checked at baseline and at the 1st and
6th months of therapy.

Results:
The baseline viral load was higher in the NR group than in the RR
and LTR groups independently of genotype; HCV-RNA levels
progressively decreased during therapy independently of response
but the levels remained significantly higher in the NR group.
Genotype 1b was prevalent in the NR group. However, levels of
viraemia in genotype 1b LTR patients are significantly lower than
in genotype 1b NR patients.

Conclusion:
These results suggest that among viral-related parameters viraemia
alone seems to play an important role in predicting response to IFN
independently of genotype.